Tag Archives: nursing homes

“Look at Bingy”: Alzheimer’s and Distraction

Frustration is part of Alzheimer’s and other age-related memory loss and dementias – frustration for the person themself and the people caring for or interacting with them.  warning on dementias ward doorOften, an Alzheimer’s person will believe something totally contrary to “reality” – it may be a big thing or a little thing.  But explaining, usually, will get you (the non-Alzheimer’s person) nowhere.  At best, your explanation will be immediately forgotten. At worst, it will create an argument and distress for both parties – really over nothing that can be resolved.

It’s very hard coping with “it’s white” statements when you know that, in fact, “it’s black”.  You can reason, you can scream, but nothing is going to convince that person.   It’s especially hard when the person is a parent or grandparent, an individual you respect and who expects respectful behaviour from you.

The Bingy Strategy

I’ve read that the best thing is distraction, and I find it works better than any long-winded explanation.  But you can’t be obvious about it.  Someone might have Alzheimer’s but that doesn’t mean they don’t pick up on patronizing behaviours.  So you have to distract Bing the dog, in service stationto something equally interesting or at least off-the-wall enough to command attention.  With luck, the attention paid to that new thing will last long enough for the problematic thing to be forgotten.   I call it the ‘look at Bingy’ strategy.  Thinking of it that way helps me as much as it does the person with whom I’m dealing.

‘Look at Bingy’ became a family catchphrase for distraction after my mother invented it out of necessity.  A guy had come to my father’s business to see him, but only my mother and the dog were there.   The guy thought Mom was a fine looking woman and put the makes on her.  She didn’t want to offend, but wanted to stop him.  So every time he’d start with ‘hows about it’ type things, she’d say “oh, look at Bingy!”  He’d turn to see what the dog was doing.  This worked for Mom at service station windowher several times, until he said “Bingy be damned!” in that Bing wasn’t actually doing much of anything.  However, it bought Mom time and Dad soon returned.  After that, whenever you were in a sticky situation and didn’t know how to get out of it, ‘look at Bingy’ was a reminder to play for time.

Don’t argue with dementias

So, with Alzheimer’s creating belief that “I don’t live here” or “I don’t have any food, I need to go shopping”, the ‘look at Bingy’ approach can forestall pointless argument.  Saying ‘you do live here, remember when you moved in?’ or ‘you have your meals in the dining room’ means nothing to someone who can’t remember where the dining room is.  Start talking about something else – the dog or cat or someplace you went on the weekend.  Just pick places and people that you think might ring a bell.  Dogs and cats are especially good.  I’ve found pets are remembered more clearly than many people, and not being able to remember them is less upsetting.

You’re not going to cure Alzheimer’s, you’re not going to bring the person’s memory back, you’re not going to ‘teach’ them anything.  The best you can do is listen, acknowledge and, yes, sometimes distract.

My Seeing the world the Alzheimer’s way has more. Also, a couple of excellent points I found on pages that are no longer online: 

…death of the mind… “if you argue with an Alzheimer’s patient, you get exactly what you deserve”

Alzheimer’s Assoc. Online Community, a poster (Dec. 31/10) gives this advice “Ring the bells that still can ring. Forget your perfect offering. There is a crack in everything. That is how the light gets in.”  Using Leonard Cohen’s words in this context is inspired –  so lovely, so true.

Seeing the world the Alzheimer’s way

walking in hallway, space and timeWith Alzheimer’s, how is space and time perceived within your head?  Take walking 20 yards down a hallway, from your room to the dining room.  Halfway through, you can’t remember where you’re going.  How can you not remember what takes maybe a minute to do, even at a walker-assisted pace?

I got a clue from something my husband said when we were trying to puzzle this out.  “Well, when you’re a little kid, a hallway can seem enormously long.  Then when you see it as an adult you realize it’s not at all.”  I said “yeah, but kids are little so they walk slow.  It takes them longer to get down the hallway  so maybe it would seem really long.”  And then the penny dropped for me.

Space and Time

If you’re old and incapacitated, it takes you longer to walk down the hallway, just like it does when you’re a child.  Add in loss of short-term memory, and maybe you indeed are empty tv room in nursing home at dinner timeon a long and winding road.  Someone with Alzheimer’s can forget what was said or done five or 10 seconds before.  Walking those 20 yards to or from the dining room takes longer than that.  So halfway down the hall, that person may have forgotten where they’re coming from or where they’re going.  They’re likely to find their way to their immediate destination because if they keep going straight, they’re going to run into it.  But an hour or two later, trying to find their way back?  Or even that there is a “back” to which to go?

It’s frustrating, also flabbergasting: “your room is down the hall” – “what hall?”  Maybe it’s a little easier to understand if you think of it as a very long walk, like a two hour trek nursing home roadway in winterfrom point A to point B through the woods.  When you reach the end, you probably can’t remember every detail of what the starting point looked like.  You’d have to go back there to refresh your memory.  With Alzheimer’s, maybe walking that hallway is more like a trek through the woods.  The staff are the signposts along the path, pointing out to walkers the right way to go. With space and time, maybe the path will be visible for at least a moment.